What Is Inability To Concentrate?[dropcap]I[/dropcap]nability to concentrate is a mental dysfunction characterized by trouble fixing the mind on one subject to the exclusion of all other thoughts.
What Is Anxiety?[dropcap]A[/dropcap]nxiety or worry is a distressing emotional state of mind or mood that is characterized by a vague uneasiness, unpleasant feelings of apprehension or anticipation of danger and by interference with normal functioning, ranging from mild qualms and easy startling to occasional panic.
Q: What causes anxiety?
A: Anxiety can be a normal response to stress such as making an important decision, illness, divorce, problems at work or preparing for an exam.
In a dangerous situation, profound physiological changes rapidly prepare us for a “fight or flight” response by release of adrenalin hormone. Adrenalin speeds up metabolism to make available quick energy, tightens muscles in readiness, and speeds up the heartbeat and breathing so that more oxygen is made available to the brain and muscles.
Anxiety becomes a maladaptive disorder when it is excessive, unrealistic, or not provoked and impairs the ability to lead a normal life.
Anxiety that is part of a person’s personality is called “trait anxiety.” Anxiety that comes and goes is “state anxiety,” as in state of mind, and is usually due to unresolved stress or an underlying health problem.
[dropcap]T[/dropcap]etany is a painful feature of low blood calcium or low blood magnesium causing hyperexcitability of all nerves which in turn stimulates involuntary sudden, intermittent and repetitious tonic spasms of muscles. Tonic spasms are steady rather than jerky.
Causes include low function of the parathyroid glands which regulate calcium blood levels, vitamin D deficiency which inhibits calcium absorption from the gut that leads to calcium deficiency, and alkalosis.
In alkalosis, the chemical pH (acid/alkaline measure) of blood is too high, or alkaline, which inhibits adequate free calcium ions from being available for cell use.
Q: Why do low blood levels of calcium or magnesium cause muscles to spasm?
A: Calcium controls the readiness of muscle to respond to nerve stimulation. In muscle action, calcium and magnesium are minerals that oppose each other. Calcium allows a muscle to contract while magnesium allows it to relax. Inadequate levels of these opposing minerals affect the ability of muscles to properly function.
A simple test for tetany is called Trouseau’s named after the doctor who developed it. A blood pressure cuff is placed on an upper arm as usual and pumped up to a pressure sufficient to stop blood flow. The pressure must be held for 3 minutes. A positive result is shown in the above photo of carpopedal spasm: the wrist and hand flexes inward while the fingers extend (opposite of wrist and hand) and the thumb goes against the palm.
[dropcap]C[/dropcap]erebral vasculitis, also called vasculitis of the central nervous system (CNS), is an autoimune attack against elastin fibers in the walls of arteries that bring blood to the head. Early recogniton may reduce poor outcomes.1
Cerebral vasculitis is characterized by inflammation of large, medium, or small blood vessels which is often segmental with scattered foci (sites) of intense inflammation, and results in necrosis (death) of affected tissues with scarring that occludes, or blocks, blood flow.
Q: What happens when an artery is occluded by scarring?
A: When an artery is occluded by scarring, blood cannot flow through it thus preventing the body tissues it supplies with oxygen and nutrition. Depending on vessels that are affected, blindness, TIA (transient ischemic attack) or stroke may result from blockage or rupture (hemorrhage).
Blood flow through arteries can be seen by angiography procedure. The diagnosis is made by biopsy. Additionally, contrast-enhanced MRI, proven to be sensitive to extradural arteritis, for the identification of intracranial vessel wall inflammation shows that wall thickening and intramural contrast uptake are frequent findings in patients with active cerebral vasculitis affecting large brain arteries.2
Vasculitis may develop with autoimmune diseases, such as celiac disease, lupus eythematosis and rheumatoid arthritis due to immune complexing, and possibly severe infection and drug sensitivity.
What Are Tremors?[dropcap]T[/dropcap]remors are repetitive patterns of involuntary muscle contraction and relaxation originating from disorder in the basal ganglia of the brain. See image of hand tremor (to left) courtesy of Antonio Piedade.
Rythmic shaking may affect various parts of the body including hands, arms, legs, trunk, tongue, or vocal cords.1
Causes include malnutrition, drug adverse effects especially antipsychotics, environmental toxins, and conditions such as Parkinson disease and thyroid disease, which causes toxic levels of thyroid hormone.
[dropcap]A[/dropcap]rachidonic acid is a major essential (must have/can’t make) omega-6 fatty acid.
Structurally, arachidonic acid is a key component of nerve membranes, together with docosahexaenoic acid (DHA), a major opposing omega-3 fatty acid, making up 15-20% of the brain’s dry mass and more than 30% of the retina.
In healthy human volunteers, positron emission tomography (PET) has shown that the normal human brain consumes 17.8 mg/day of arachidonic acid.1
Arachidonic acid is particularly concentrated in highly active membranes such as nerve synapses (junctions) and in photoreceptors in the eye retina.2
Arachidonic acid is an important building substance for the eicosanoids.
Q: What function do the eicosanoids have that are derived from arachidonic acid?
A: Eicosanoids are a large group of highly bioactive hormone-like substances including prostaglandins, leukotrienes, and thromboxanes that are involved in blood clotting, inflammation, and vasoconstriction. Eicosanoids derived from arachidonic acid are pro-inflammatory, pro-blood clotting, and constrict blood vessels in opposition to those derived from the omega-3 fatty acids which do the opposite in order to keep a balance in the body.
[dropcap]S[/dropcap]chizophrenia is a thought disorder characterized by psychotic symptoms and inappropriate and bizarre behavior.
Schizophrenia involves dysfunction in any of these areas:
Q: What are psychotic symptoms?
A: In psychosis the symptoms vary but include loss of contact with reality shown by hallucinations, delusions, disorganized speech, and disorientation. Some may be depressed or manic. Some may be withdrawn and mute while others may become violent if frustrated or thwarted.
In hallucinations, affected persons see what is not real such as a burgler in the process of robbing them but which is not really happening or hear voices that are not real.
In delusions, affected persons may express strange ideas, claim to read minds or that they are a famous person living or dead.
Early-onset schizophrenia with onset before age 18 is defined by the same diagnostic criteria as in adults because it is continuous with adult schizophrenia. The onset before age 12 years comprises less than 1% of adult cases, and onset from age 12–18 years constitutes about 12–33% of all adult cases of schizophrenia.1
[dropcap]P[/dropcap]rogressive multifocal leukoencephalopathy is a progressive demyelinating disorder of the central nervous system (brain) caused by JC virus that leads to rapid death.
Progressive multifocal leukoencephalopathy usually occurs as an opportunistic infection in patients with underlying depression of cell-mediated immunity. It has been recognized that the JC virus is highly prevalent in the adult population, with 50–90% of healthy individuals having been exposed to the virus. Approximately 85% of the population has antibodies to JC virus. The virus’ purported site of latency in the human body is currently under debate.1
Progressive multifocal leukoencephalopathy is characterized by tissue loss of subcortical white matter (brain tissue) and active perivascular inflammatory foci (locations in blood vessels) with numerous eosinophilic granulocytes (white blood cells).
Q: What is demyelinating?
A: Demyelinating means there is damage to the myelin sheath of nerve cells called oligodendrites in the brain. In this disorder the damaged, irregular areas caused by the infection get progressively bigger.
The myelin sheath is a fatty substance that surrounds and protects nerve cells and enhances the transmission of nerve impulses much like the covering of a lamp cord keeps the electricity flowing within it from the plug to the light bulb. Damage to the myelin sheath impairs transmission of nerve impulses in the way that fraying an electric cord impairs the flow of electricity.
What Is Progressive Myoclonic Ataxia?[dropcap]P[/dropcap]rogressive myoclonic ataxia is a movement disorder characterized by defective muscular coordination of a muscle group with its origin in the brain.
The pathology is in the cerebellum.1
Myoclonus in a context of progressive ataxia suggests one clinical form of the Ramsay-Hunt syndrome (progressive myoclonic ataxia, PMA), whose most frequent causes are: celiac disease, mitochondriopathies, some spino-cerebellar degenerations, and some late metabolic disorders.2
[dropcap]M[/dropcap]igraine is a neurologic disorder characterized by reduced cerebral blood flow that causes a severe headache. The pain is usually on one side of the head, pulsates, and is aggravated by bodily exertion that increases blood pressure.
The type of migraine can be classic with an aura or non-classic without an aura.
Classic migraine begins with an aura that develops over minutes and may last up to an hour before, during, or after the headache. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.
Q: What does the aura signify?
A: According to the International Headache Society, an aura signifies an area of brain dysfunction. An aura is different from a trigger. A trigger brings on a migraine while an aura is a response to decreased blood flow.
A study investigating what triggers a migraine found these statistics in 1027 participants of whom 75.9% reported triggers (40.4% infrequently, 26.7% frequently and 8.8% very frequently).
The trigger frequencies were stress (79.7%), hormones in women (65.1%), not eating (57.3%), weather (53.2%), sleep disturbance (49.8%), perfume or odour (43.7%), neck pain (38.4%), light(s) (38.1%), alcohol (37.8%), smoke (35.7%), sleeping late (32.0%), heat (30.3%), food (26.9%), exercise (22.1%) and sexual activity (5.2%).1
Migraine affects about 12% of the U.S. general popululation. It is three times more common in women than in men.